NYAPRS Note: The below note outlines DOH’s innovation plan that could generate billions of dollars in savings from avoidable readmissions. Advocates in the behavioral health community have voiced concerns since it’s draft was made public, though, that adequate attention to disparities and the use of critical community-based interventions such as peer support and adequate housing is not afforded in the report. The deadline for submitting comments (see link at bottom of page) is tomorrow, 11/27.

DOH Seeks Millions from Feds to Innovate

New York state health officials have drafted a far-reaching plan that, if successful, could slash avoidable hospital admissions and readmissions by 20% in five years, and generate $5 billion to $10 billion in savings within 10 years. The plan would reduce unnecessary care, shift care to appropriate settings and curb increases in unit prices for health care products and services that are not tied to quality.

"Our goal is to bring the growth of health care spending more closely in line with the growth of our economy," while improving health outcomes, wrote state Department of Health regulators in explaining the proposal, called the State Healthcare Innovation Plan.

Public comments are due on Nov. 27 for input on SHIP, a sweeping blueprint for change that if approved could attract $40 million to $60 million in federal funding. The plan is the basis for an application for funding from the Centers for Medicare and Medicaid Innovation. CMMI awarded New York a $1 million grant in April to plan SHIP.

SHIP's goal is to identify promising innovations in health care delivery and finance. SHIP would pave the way for the state to support innovations in health care delivery and spread them throughout New York.

The state's plan relies heavily on boosting primary and coordinated care for New Yorkers. It wants to cut by 50% the number of adults who do not have a regular doctor, cut the number of uninsured by 1 million, and slash waiting times at safety-net providers.

A key element of SHIP is developing "advanced primary care," a concept that builds on the patient-centered medical home. Primary care providers would take on responsibility for coordinating the complete health and social care needs of their patients in a comprehensive population health management model. Ambitiously, the plan calls for 80% of New Yorkers being in this APC model in five years—a goal with many hurdles in implementation.

Still, SHIP is creating much buzz in health care circles.

The plan "would mark a fundamental shift in how health care is delivered and paid for in New York state," said a spokesman for the Primary Care Development Corp. "The plan sets out new rules of the road, tells primary care providers they're going to be in the driver's seat, and encourages them to go get licenses and take control."